Appendicitis Research

BACK

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1. Appendectomy.

Subfile: Digestive Diseases

Format (FM): BOOK CHAPTER (09).

Language(s) (LG): English.

Year Published (YR): 2003.

Audience code (AC): HEALTH PROFESSIONALS (100).

Author (AU): Schier, F.

Source (SO): In: Schier, F. Laparoscopy in Children. Heidelberg, Germany: Springer-Verlag. 2003. p.36-47.

Availability (AV): Available from Springer-Verlag. Tiergartenstr. 17, D-69121 Heidelberg, Germany. (49)6221-487-0. Website: www.springer.de. E-mail: orders@springer.de. PRICE: $69.95 plus shipping and handling. ISBN: 3540429751.

Abstract (AB): Most surgeons are familiar with the techniques of laparoscopic surgery, however, in children there are variations in size and technical approach. This section on laparoscopic appendectomy is from a book that describes the differences and characteristic aspects of laparoscopy in small children. The book is an atlas of numerous drawings, accompanied by textual descriptions. Technical guidelines are given on how to perform the laparoscopic appendectomy safely, even in small children. Illustrations depict the instruments used, the technique of locating and isolating the appendix, ligation techniques, and the operating table layout and trocar placement. The aim of the book is to provide surgeons with the knowledge to extend their expertise in adult laparoscopy to children. 12 figures.

Major Descriptors (MJ): Digestive System Diseases. Laparoscopy. Appendectomy. Surgery. Surgical Techniques. Guidelines. Children. Infants. Patient Care Management.

Minor Descriptors (MN): Continuing Education. Equipment and Supplies. Anatomy.

Verification/Update Date (VE): 200304.

Notes (NT): CP: Yes.

Accession Number (AN): DD BK 09445.

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2. Appendectomy Is Followed by Increased Risk of Crohn’s Disease.

Subfile: Digestive Diseases

Format (FM): JOURNAL ARTICLE (24). REVIEW (46).

Language(s) (LG): English.

Year Published (YR): 2003.

Audience code (AC): HEALTH PROFESSIONALS (100).

Author (AU): Andersson, R.E., et al.

Source (SO): Gastroenterology. 124(1): 40-46. 2003.

Availability (AV): Available from W.B. Saunders Company. 6277 Sea Harbor Drive, Orlando, FL 32887-4800. (800) 654-2452. Website: www.gastrojournal.org.

Abstract (AB): Appendectomy is associated with a low risk of subsequent ulcerative colitis (UC, a type of inflammatory bowel disease). This article reports on a study of the risk of Crohn’s disease (a second type of inflammatory bowel disease) after appendectomy. The authors followed-up 212,218 patients with appendectomy before age 50 years and a cohort of matched controls, identified from the Swedish Inpatient Register and the nationwide Census, for any subsequent diagnosis of Crohn’s disease. An increased risk of Crohn’s disease was found for more than 20 years after appendectomy, with incidence rate ratio 2.11 after perforated appendicitis, 1.85 after nonspecific abdominal pain, 2.15 after mesenteric lymphadenitis, 2.52 after other diagnoses. After nonperforated appendicitis, there was an increased risk among women but not among men. Patients operated on before age 10 years had a low risk. Crohn’s disease patients with a history of perforated appendicitis had a worse prognosis. 2 figures. 5 tables. 29 references.

Major Descriptors (MJ): Digestive System Diseases. Crohns Disease. Etiology. Risk Factors. Appendectomy. Postoperative Complications.

Minor Descriptors (MN): Inflammatory Bowel Disease. Sex Factors. Age Factors. Incidence. Diagnosis. Appendicitis. Emergencies. Abdominal Pain.

Verification/Update Date (VE): 200304.

Notes (NT): CP: Yes.

Accession Number (AN): DD JA 09414.

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3. Acute Appendicitis.

Subfile: Digestive Diseases

Format (FM): BOOK CHAPTER (09).

Language(s) (LG): English.

Year Published (YR): 2003.

Audience code (AC): PATIENT (400).

Corporate Author (CN): PDxMD.

Series (SE): [PDxMD Medical Condition Series].

Source (SO): In: PDxMD. PDxMD Gastroenterology. St. Louis, MO: Elsevier Science. 2003. p. 1-14.

Availability (AV): Available from Elsevier Science. Customer Service Department, 11830 Westline Industrial Drive, St. Louis, MO 63146. (800) 545-2522. Fax (800) 535-9935. Email: usbkinfo@elsevier.com. Website: www.elsevierhealth.com. PRICE: $39.95. ISBN: 932141049.

Abstract (AB): Acute appendicitis is characterized by central abdominal pain usually lasting several hours, with brief cessation, followed by migration of pain to the right lower quadrant in a more constant, more localized form. Nausea, anorexia (lack of appetite), and fever are common. Delayed diagnosis may result in perforation, peritonitis, and greatly increased morbidity and mortality. This chapter on acute appendicitis is from a book on gastroenterology that offers concise, action-oriented recommendations for primary care medicine. The chapter covers summary information and background on the condition, and comprehensive information on diagnosis, treatment, outcomes, and prevention. Specific topics covered include the ICD9 code, urgentaction, synonyms, cardinal features, causes (etiology), epidemiology, differential diagnosis, signs and symptoms, associated disorders, investigation of the patient, appropriate referrals and consultations, diagnostic considerations, clinical tips, treatment options, patient management issues, drug therapies, prognosis, complications, and how to prevent recurrence. The information is provided in outline and bulleted format for ease of accessibility. The final section of the chapter offers resources, including related associations, key references, and the answers to frequently asked questions (FAQs). 8 references.

Major Descriptors (MJ): Digestive System Diseases. Symptoms. Diagnosis. Therapy. Patient Care Management. Prevention. Guidelines. Appendicitis.

Minor Descriptors (MN): Diagnostic Tests. Risk Factors. Delivery of Health Care. Prognosis. Complications. Prevention. Drug Therapy. Emergencies. Morbidity. Mortality. Abdominal Pain.

Verification/Update Date (VE): 200404.

Notes (NT): CP: Yes.

Accession Number (AN): DD BK 10046.

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4. Factors Associated with Conversion to Laparotomy in Patients Undergoing Laparoscopic Appendectomy.

Subfile: Digestive Diseases

Format (FM): JOURNAL ARTICLE (24).

Language(s) (LG): English.

Year Published (YR): 2002.

Audience code (AC): HEALTH PROFESSIONALS (100).

Author (AU): Liu, S., et al.

Source (SO): Journal of the American College of Surgeons. 193(3): 298-305. March 2002.

Availability (AV): Available from Journal of the American College of Surgeons. P.O. Box 2127, Marion, OH 43306-8227. (800) 214-8489 or (740) 382-3322. Fax (740) 382-5866.

Abstract (AB): Laparoscopic appendectomy (LA) has been increasingly adopted for its advantages over the open technique, but there is a possibility of conversion to open appendectomy (OA) if complications occur or the extent of inflammation of the appendix prohibits successful dissection. This article reports on a study undertaken to identify the preoperative predictors for conversion from laparoscopic to open appendectomy. The authors retrospectively reviewed the medical records of 705 consecutive patients who underwent surgery for suspected appendicitis (inflamed appendix). LA was attempted in 595 patients by 25 different surgeons. Conversion to OA occurred in 58 of these 595 patients (9.7 percent). The most common reason for conversion was dense adhesions due to inflammation, followed by localized perforation and diffuse peritonitis. Based on 261 patients evaluated by CT scan preoperatively, significant factors associated with conversion to OA were age, diffuse tenderness on physical examination, and a surgeon with less experience. The presence of significant fat stranding associated with fluid accumulation, inflammatory mass, or localized abscess in CT scan also significantly increased the possibility of conversion. 5 tables. 38 references.

Major Descriptors (MJ): Digestive System Diseases. Appendectomy. Laparoscopy. Surgical Techniques. Patient Selection. Preoperative Care.

Minor Descriptors (MN): Risk Factors. Complications. Surgery. Patient Care Management. Appendicitis. Diagnostic Tests. CAT Scan. Inflammation. Abdominal Pain.

Verification/Update Date (VE): 200210.

Notes (NT): CP: Yes.

Accession Number (AN): DD JA 09206.

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5. Factors Associated with Conversion to Laparotomy in Patients Undergoing Laparoscopic Appendectomy.

Subfile: Digestive Diseases

Format (FM): JOURNAL ARTICLE (24).

Language(s) (LG): English.

Year Published (YR): 2002.

Audience code (AC): HEALTH PROFESSIONALS (100).

Author (AU): Liu, S., et al.

Source (SO): Journal of the American College of Surgeons. 193(3): 298-305. March 2002.

Availability (AV): Available from Journal of the American College of Surgeons. P.O. Box 2127, Marion, OH 43306-8227. (800) 214-8489 or (740) 382-3322. Fax (740) 382-5866.

Abstract (AB): Laparoscopic appendectomy (LA) has been increasingly adopted for its advantages over the open technique, but there is a possibility of conversion to open appendectomy (OA) if complications occur or the extent of inflammation of the appendix prohibits successful dissection. This article reports on a study undertaken to identify the preoperative predictors for conversion from laparoscopic to open appendectomy. The authors retrospectively reviewed the medical records of 705 consecutive patients who underwent surgery for suspected appendicitis (inflamed appendix). LA was attempted in 595 patients by 25 different surgeons. Conversion to OA occurred in 58 of these 595 patients (9.7 percent). The most common reason for conversion was dense adhesions due to inflammation, followed by localized perforation and diffuse peritonitis. Based on 261 patients evaluated by CT scan preoperatively, significant factors associated with conversion to OA were age, diffuse tenderness on physical examination, and a surgeon with less experience. The presence of significant fat stranding associated with fluid accumulation, inflammatory mass, or localized abscess in CT scan also significantly increased the possibility of conversion. 5 tables. 38 references.

Major Descriptors (MJ): Digestive System Diseases. Appendectomy. Laparoscopy. Surgical Techniques. Patient Selection. Preoperative Care.

Minor Descriptors (MN): Risk Factors. Complications. Surgery. Patient Care Management. Appendicitis. Diagnostic Tests. CAT Scan. Inflammation. Abdominal Pain.

Verification/Update Date (VE): 200301.

Notes (NT): CP: Yes.

Accession Number (AN): DD JA 09399.

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6. Appendicitis: Should Diagnostic Imaging Be Performed if the Clinical Presentation is Highly Suggestive of the Disease?.

Subfile: Digestive Diseases

Format (FM): JOURNAL ARTICLE (24).

Language(s) (LG): English.

Year Published (YR): 2002.

Audience code (AC): HEALTH PROFESSIONALS (100).

Author (AU): Rettenbacher, T., et al.

Source (SO): Gastroenterology. 123(4): 992-998. October 2002.

Availability (AV): Available from W.B. Saunders Company. 6277 Sea Harbor Drive, Orlando, FL 32887-4800. (800) 654-2452. Website: www.gastrojournal.org.

Abstract (AB): This article reports on a study that investigated whether diagnostic imaging is required if the clinical presentation suggests acute appendicitis with high probability. On the basis of clinical findings, 350 consecutive patients with clinical suspicion of acute appendicitis were prospectively divided into 3 groups as follows: low, intermediate, and high probability of having appendicitis. All patients then underwent diagnostic ultrasonography. The clinical likelihood of appendicitis and the ultrasonography results were correlated with the definite diagnoses. In the patients with clinically low probability of having appendicitis, appendicitis was present in 10 percent (11 of 109 patients), and, in those with intermediate probability, appendicitis was present in 24 percent (23 of 97 patients). Patients with clinically high probability of having appendicitis had appendicitis in 65 percent (94 of 144 patients), an alternative diagnosis in 18 percent (26 of 144 patients), and no specific definitive diagnosis in 17 percent (24 of 144 patients). The authors conclude that even in patients with clinically high probability of acute appendicitis, diagnostic imaging should be performed because it accurately depicts a high percentage of normal appendices and differential diagnoses. 1 figure. 5 tables. 37 references.

Major Descriptors (MJ): Digestive System Diseases. Appendicitis. Diagnostic Tests. Patient Selection. Test Reliability. Symptoms. Physical Examination.

Minor Descriptors (MN): Diagnosis. Patient Care Management. Abdominal Pain. Ultrasound.

Verification/Update Date (VE): 200304.

Notes (NT): CP: Yes.

Accession Number (AN): DD JA 09358.

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7. Appendicitis.

Subfile: Digestive Diseases

Format (FM): BOOK CHAPTER (09).

Language(s) (LG): English.

Year Published (YR): 2002.

Audience code (AC): HEALTH PROFESSIONALS (100).

Author (AU): Sarosi, Jr., G.A.; Turnage, R.H.

Source (SO): In: Feldman, M.; Friedman, L.S.; Sleisenger, M.H. Sleisenger and Fordtran’s Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 7th ed. [2-volume set]. St. Louis, MO: Saunders. 2002. p. 2089-2099.

Availability (AV): Available from Elsevier. 11830 Westline Industrial Drive, St. Louis, MO 63146. (800) 545-2522. Fax (800) 568-5136. Website: www.us.elsevierhealth.com. PRICE: $229.00 plus shipping and handling. ISBN: 0721689736.

Abstract (AB): Appendicitis is the most common acute abdominal emergency seen in developed countries. This chapter on appendicitis is from a comprehensive and authoritative textbook that covers disorders of the gastrointestinal tract, biliary tree, pancreas, and liver, as well as the related topics of nutrition and peritoneal disorders. Topics include historical perspective, epidemiology, anatomy and embryology, pathology, pathogenesis, diagnosis, clinical presentation, diagnostic accuracy, complications, treatment, and anticipated treatment outcomes. Simple acute appendicitis is associated with excellent outcomes. Morbidity and mortality attributable to appendicitis increase markedly with complicated and in particular, perforated appendicitis. The treatment of acute appendicitis remains appendectomy. The chapter includes a mini-outline with page citations, illustrations, and extensive references. 4 figures. 2 tables. 80 references.

Major Descriptors (MJ): Digestive System Diseases. Gastroenterology. Pathophysiology. Diagnosis. Patient Care Management. Appendicitis. Physiology. Symptoms.

Minor Descriptors (MN): Appendectomy. Diagnostic Tests. Professional Education. Pathology. Complications. Etiology. Epidemiology. Prognosis. Emergencies. Abdominal Pain. Mortality. Morbidity.

Verification/Update Date (VE): 200310.

Notes (NT): CP: Yes.

Accession Number (AN): DD BK 09647.

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8. Ulcerative Colitis of the Appendix (‘Ulcerative Appendicitis’) Mimicking Acute Appendicitis.

Subfile: Digestive Diseases

Format (FM): JOURNAL ARTICLE (24).

Language(s) (LG): English.

Year Published (YR): 2001.

Audience code (AC): HEALTH PROFESSIONALS (100).

Author (AU): Barclay, R.L., et al.

Source (SO): Canadian Journal of Gastroenterology. 15(3): 201-204. March 2001.

Availability (AV): Available from Pulsus Group, Inc. 2902 South Sheridan Way, Oakville, Ontario, Canada L6J 7L6. Fax (905) 829-4799. E-mail: pulsus@pulsus.com.

Abstract (AB): The appendix may be involved in ulcerative colitis (UC, a type of inflammatory bowel disease), in the setting of either diffuse or distal disease, and is usually diagnosed incidentally at the time of proctocolectomy (surgery to treat the UC). This article describes a patient in whom a rare case of ‘ulcerative appendicitis’ occurring on a background of clinically quiescent (no active symptoms) UC presented with the signs and symptoms of acute appendicitis. Prior to this presentation, the patient’s UC was in remission for over 2 years. The patient was treated with laparotomy and the appendix was removed. Pathology showed acute inflammation confined to the mucosa, with neutrophilic crypt epithelial infiltration (cryptitis) and crypt abscesses consistent with appendix involvement by UC. Following appendectomy, the patient made a rapid and uneventful recovery; he was asymptomatic one day after the operation and was discharged home on day 2. Six months later, the colitis remained in complete clinical remission, and there has been no recurrence of right lower quadrant symptoms. The authors suggest that this patient’s acute appendiceal pain syndrome derived from a complex interplay of mucosal immune, vascular, and neurogenic factors, driven by a localized, active focus of UC. Appendectomy provided both the diagnosis and the cure of this acute illness. The authors conclude that although rare (and perhaps underrecognized), acute right lower quadrant pain in the setting of clinically quiescent UC may herald active ulcerative appendicitis, rather than typical suppurative appendicitis. 1 figure. 24 references.

Major Descriptors (MJ): Digestive System Diseases. Ulcerative Colitis. Appendix. Appendicitis. Case Reports.

Minor Descriptors (MN): Diagnosis. Patient Care Management. Appendectomy. Symptoms. Abdominal Pain. Inflammatory Bowel Disease. Etiology.

Verification/Update Date (VE): 200110.

Notes (NT): CP: Yes.

Accession Number (AN): DD JA 08394.

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9. Is the Appendix a Vestigial Organ? Its Role in Ulcerative Colitis.

Subfile: Digestive Diseases

Format (FM): JOURNAL ARTICLE (24). REVIEW (46).

Language(s) (LG): English.

Year Published (YR): 2001.

Audience code (AC): HEALTH PROFESSIONALS (100).

Author (AU): Binder, H.J.

Source (SO): Gastroenterology 121(3): 730-737. September 2001.

Availability (AV): Available from W.B. Saunders Company. 6277 Sea Harbor Drive, Orlando, FL 32887-4800. (800) 654-2452. Website: www.gastrojournal.org.

Abstract (AB): This article summarizes a research study that considers the role of the appendix in ulcerative colitis (UC, a type of inflammatory bowel disease), including the possible role of appendectomy (removal of the appendix) in protecting against UC. The author briefly reviews the research in this area, then focuses on one particular study that was reported in the New England Journal of Medicine in 2001 (Andersson, R.E., et al, Volume 344). The investigators in that study conclude that the inflammatory response leading to an appendectomy rather than the removal of the appendix was the significant clinical factor negatively associated with developing UC at a later date. The absence of this protective effect in older patients with appendicitis also suggests that the immune mechanisms resulting in appendicitis in these patients may differ from those resulting in appendicitis before the third decade. The author then appends a lengthy commentary exploring the ramifications of these results. The author concludes that in the absence of evidence supporting a more causal role for the appendix, adoption of therapeutic appendectomy as a strategy to affect the incidence or clinical course of UC is premature, despite recent case reports suggesting clinical improvement and reduction in mucosal inflammatory mediators after appendectomy. Numerous studies are referred to in the text of this article.

Major Descriptors (MJ): Digestive System Diseases. Ulcerative Colitis. Appendectomy. Appendix. Etiology. Complications. Inflammation.

Minor Descriptors (MN): Risk Factors. Inflammatory Bowel Diseases. Therapy. Patient Care Management. Pathology. Research.

Verification/Update Date (VE): 200204.

Notes (NT): CP: Yes.

Accession Number (AN): DD JA 08790.

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10. Prevalence of Appendectomy Among Ulcerative Colitis Patients and Their Relatives.

Subfile: Digestive Diseases

Format (FM): JOURNAL ARTICLE (24).

Language(s) (LG): English.

Year Published (YR): 2001.

Audience code (AC): HEALTH PROFESSIONALS (100).

Author (AU): Lopez-Ramos, D, et al.

Source (SO): European Journal of Gastroenterology and Hepatology. 13(10): 1231-1233. October 2001.

Availability (AV): Available from Lippincott Williams and Wilkins. 241 Borough High Street, London SE1 1GB, UK 44(0)20-7940-7502. Fax: 44(0)20-7940-7574. Website: http://www.eurojgh.com/.

Abstract (AB): It has been suggested that appendectomy (removal of the appendix) may protect against ulcerative colitis (UC). However, the incidences of appendectomy and UC in developed countries have diverged over the last 50 years, possibly as a consequence of environmental factors. This study was undertaken to determine whether the incidence of appendectomy is lower in patients with UC than in the general population. Patients with UC (n = 153), their relatives (n = 116), and members of the general population (n = 306) that had been matched for age, sex, and educational status were studied. Six percent of UC patients had undergone appendectomy. The corresponding figure for non family controls was 20 percent. The rate of appendectomy within families (cases plus siblings) was 17 of 269 patients (6.3 percent) and was similar to that for UC patients alone. A negative association between appendectomy and UC exists in our patients with UC. In addition, the appendectomy rate in families of UC patients was lower than that in the general population, possibly implying that common environmental and genetic factors could play an important role in the divergent incidences of appendicitis and UC over the last 50 years. 2 tables. 18 references.

Major Descriptors (MJ): Digestive System Diseases. Ulcerative Colitis. Appendectomy. Appendix. Etiology. Complications. Inflammation. Risk Factors.

Minor Descriptors (MN): Genetics. Environmental Factors. Family. Inflammatory Bowel Diseases. Therapy. Patient Care Management. Pathology. Research.

Verification/Update Date (VE): 200204.

Notes (NT): CP: Yes.

Accession Number (AN): DD JA 08791.

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11. Appendicitis in Children: New Insights Into an Old Problem.

Subfile: Digestive Diseases

Format (FM): JOURNAL ARTICLE (24).

Language(s) (LG): English.

Year Published (YR): 2000.

Audience code (AC): HEALTH PROFESSIONALS (100).

Author (AU): Gregory, T., ed.

Source (SO): Patient Care. 34(5): 183-188, 191-195. March 15, 2000.

Availability (AV): Available from Medical Economics. 5 Paragon Drive, Montvale, NJ 07645. (800) 432-4570. Fax (201) 573-4956.

Abstract (AB): Acute appendicitis is the most common reason for emergency abdominal surgery in childhood. Despite strong emphasis on early surgical intervention, the morbidity and mortality of acute appendicitis in children remain high. This review article clarifies the symptoms to look for in the patient’s history, the signs to assess during the physical examination, and the degree of confidence to place in various laboratory tests and radiologic studies. The authors reiterate that a thorough but speedy evaluation is essential when examining a child with possible appendicitis. Recent studies show that in ambiguous cases, computed tomography (CT scan), especially when performed with rectal contrast, is an excellent adjudicator. The authors review the anatomy and physiology of the appendix, then detail each step of the physical examination. After a discussion of the appropriate laboratory tests, the authors remind readers of the more common pediatric illnesses that mimic appendicitis, including gastroenteritis, constipation, mesenteric adenitis, urinary tract infection (UTI), inflammatory bowel disease (IBD), pelvic inflammatory disease (PID), ovarian cyst, and pneumonia. 8 figures. 2 tables. 22 references.

Major Descriptors (MJ): Digestive System Diseases. Children. Appendicitis. Diagnosis. Diagnostic Tests.

Minor Descriptors (MN): Morbidity. Gastrointestinal Diseases. Anatomy. Physiology. Appendix. Abdominal Pain. Symptoms. Epidemiology. Patient Care Management. Physical Examination.

Verification/Update Date (VE): 200007.

Notes (NT): CP: Yes.

Accession Number (AN): DD JA 07704.

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12. Acute Appendicitis: Review and Update.

Subfile: Digestive Diseases

Format (FM): JOURNAL ARTICLE (24). REVIEW (46).

Language(s) (LG): English.

Year Published (YR): 1999.

Audience code (AC): HEALTH PROFESSIONALS (100).

Author (AU): Hardin, D.M., Jr.

Source (SO): American Family Physician. 60(7): 2027-2034. November 1, 1999.

Availability (AV): Available from American Academy of Family Physicians. 11400 Tomahawk Creek Parkway, Leawood, KS 66211-2672. (800) 274-2237. Website: www.aafp.org.

Abstract (AB): This article reviews the diagnosis of appendicitis, a common illness, with a lifetime occurrence of 7 percent. Abdominal pain and anorexia (lack of appetite) are the predominant symptoms. The most important physical examination finding is right lower quadrant tenderness to palpation. A complete blood count and urinalysis are sometimes helpful in determining the diagnosis and supporting the presence or absence of appendicitis. Computed tomography (CT) scans and ultrasonography of the appendix can be helpful in equivocal cases. Delay in diagnosing appendicitis increases the risk of perforation and complications. The author notes that complication and mortality rates are much higher in children and the elderly. The author reiterates that prompt diagnosis of appendicitis ensures timely treatment and prevents complications. Because abdominal pain is a common presenting symptom in outpatient care, family physicians serve an important role in the diagnosis of appendicitis. Obvious cases of appendicitis require urgent referral, while equivocal cases warrant further evaluation and, many times, surgical consultation. 5 figures. 5 tables. 20 references.

Major Descriptors (MJ): Digestive System Diseases. Appendicitis. Diagnosis. Symptoms. Patient Care Management.

Minor Descriptors (MN): Diagnostic Tests. Children. Abdominal Pain. Morbidity. Mortality. Complications. Delivery of Health Care.

Verification/Update Date (VE): 200108.

Notes (NT): CP: Yes.

Accession Number (AN): DD JA 07517.

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13. Appendicitis: Symptoms are More Subtle in Older Adults.

Subfile: Digestive Diseases

Format (FM): NEWSLETTER ARTICLE (35).

Language(s) (LG): English.

Year Published (YR): 1999.

Audience code (AC): PATIENT (400). GENERAL PUBLIC (300).

Corporate Author (CN): Mayo Clinic Health Letter.

Source (SO): Mayo Clinic Health Letter. 17(9): 7. September 1999.

Availability (AV): Available from Mayo Clinic Health Letter. Subscription Services, P.O. Box 53889, Boulder, CO 80322-3889. (800) 333-9037 or (303) 604-1465.

Abstract (AB): This brief health education newsletter article reviews appendicitis and its occurrence in older adults. The author cautions that in older adults, appendicitis can be more subtle and difficult to detect. The appendix is a small, tubular pouch that projects from the large intestine; it has no known function in humans. Problems can arise when the appendix becomes blocked by fecal matter, ingested material, tissue swelling or, rarely, a tumor. Acute appendicitis occurs when the appendix becomes inflamed and swollen. Symptoms include pain that starts in mid abdomen and then shifts to the lower right, nausea, loss of appetite, vomiting, low grade fever that begins after other symptoms, and abdominal swelling. Appendicitis can be hard to diagnose because symptoms can resemble those of bladder infection, kidney stones, inflammation of the small bowel, colon or stomach, and, in women, ovarian cysts or pelvic infection. The article reviews the steps that should be taken if appendicitis is suspected. Because many conditions can mimic appendicitis, final confirmation of the condition may be possible only after the appendix has been removed and examined. Doctors use either traditional abdominal surgery or laparoscopic surgery to remove an appendix. 1 figure.

Major Descriptors (MJ): Digestive System Diseases. Appendicitis. Symptoms. Adults. Aged. Diagnosis. Surgery.

Minor Descriptors (MN): Physiology. Diagnostic Tests. Complications. Laparoscopy. Pain.

Verification/Update Date (VE): 200007.

Notes (NT): CP: Yes.

Accession Number (AN): DD JA 07680.

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14. Appendicitis.

Subfile: Digestive Diseases

Format (FM): BOOK CHAPTER (09).

Language(s) (LG): English.

Year Published (YR): 1999.

Audience code (AC): HEALTH PROFESSIONALS (100).

Author (AU): Stoker, M.E.; Becker, J.M.

Source (SO): In: Brandt, L., et al., eds. Clinical Practice of Gastroenterology. Volume One. Philadelphia, PA: Current Medicine. 1999. p. 733-738.

Availability (AV): Available from W.B. Saunders Company. Order Fulfillment, 6277 Sea Harbor Drive, Orlando, FL 32887. (800) 545-2522. Fax (800) 874-6418 or (407) 352-3445. Website: www.wbsaunders.com. PRICE: $235.00 plus shipping and handling. ISBN: 0443065209 (two volume set); 0443065217 (volume 1); 0443065225 (volume 2).

Abstract (AB): This chapter on appendicitis is from a lengthy textbook that brings practitioners up to date on the complexities of gastroenterology practice, focusing on the essentials of patient care. The authors of this chapter review the incidence, etiology, pathophysiology, anatomy, microbiology, diagnosis, and treatment of appendicitis; with an additional section on appendicitis in special circumstances, including in patients with AIDS, in pregnancy, in the young and elderly, periappendiceal abscess, and chronic appendicitis. Appendicitis continues to be one of the most common surgical emergencies in clinical practice. With a long differential diagnosis and varied presentation (symptoms), the diagnosis of acute appendicitis can be challenging. Prompt diagnosis and appendectomy (removal of the appendicitis) remain important for preventing sepsis. 3 figures. 25 references.

Major Descriptors (MJ): Digestive System Diseases. Gastroenterology. Appendicitis. Patient Care Management. Diagnosis. Etiology. Therapy.

Minor Descriptors (MN): Pathophysiology. Symptoms. Professional Education. Diagnostic Tests. Risk Factors. Appendectomy.

Verification/Update Date (VE): 200010.

Notes (NT): CP: Yes.

Accession Number (AN): DD BK 07833.

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15. Appendicitis: Unmasking the Great Masquerader.

Subfile: Digestive Diseases

Format (FM): JOURNAL ARTICLE (24). REVIEW (46).

Language(s) (LG): English.

Year Published (YR): 1998.

Audience code (AC): HEALTH PROFESSIONALS (100).

Author (AU): Hamilton, J., et al.

Corporate Author (CN): Patient Care.

Source (SO): Patient Care. 32(12): 140, 142-143, 147-150, 155-156. July 15, 1998.

Availability (AV): Available from Medical Economics. 5 Paragon Drive, Montvale, NJ 07645. (800) 432-4570. Fax (201) 573-4956.

Abstract (AB): Appendicitis used to be a purely clinical diagnosis, with a goal of surgery as early as possible to avoid perforation. This article describes a new focused CT technique that has proven very accurate in identifying the normal and abnormal appendix and in reducing unnecessary surgery. Topics covered are the signs and symptoms of appendicitis, including measures used to evaluate abdominal pain; the laboratory findings that may be expected; atypical appendicitis; special populations such as children; differential diagnosis; and the use of a focused appendiceal CT (FACT) scan. For this test, contrast material is introduced into the colon through a small rubber rectal catheter. This is followed by contiguous thin-collimation helical scanning of the right lower quadrant of the abdomen. The procedure takes less than 15 minutes with minimal patient discomfort and exposure to radiation. FACT requires experienced radiologists who are interested in becoming proficient at performing and interpreting appendiceal scans and who are willing to be available at all hours. One sidebar considers the ethical concerns over the rebound tenderness test, which some consider inhumane because it causes the patient pain. 12 figures. 1 table. 12 references.

Major Descriptors (MJ): Digestive System Diseases. Appendicitis. Diagnosis. Diagnostic Tests. Symptoms.

Minor Descriptors (MN): CAT Scan. Pain. Children. Morbidity. Complications. Delivery of Health Care. Radiography.

Verification/Update Date (VE): 199901.

Notes (NT): CP: Yes.

Accession Number (AN): DD JA 06716.

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16. Is Laparoscopic Appendectomy the New ‘Gold Standard’?

Subfile: Digestive Diseases

Format (FM): JOURNAL ARTICLE (24).

Language(s) (LG): English.

Year Published (YR): 1995.

Audience code (AC): HEALTH PROFESSIONALS (100).

Author (AU): Heinzelmann, M., et al.

Source (SO): Archives of Surgery. 130(7): 782-785. July 1995.

Abstract (AB): This article reports on a study to determine the efficacy of laparoscopic appendectomy compared with open appendectomy in patients with acute appendicitis and to compare the morbidity between the two groups. The study consisted of prospective sampling of 102 patients who underwent diagnostic laparoscopy and laparoscopic appendectomy for acute appendicitis and a retrospective hospital chart review of 204 patients who underwent open appendectomy for acute appendicitis. The mean duration of surgery was 83 minutes in the laparoscopic group and 64 minutes in the open appendectomy group. Hospital stay was shorter in the laparoscopic group. There was no difference in the complication rate between the two groups. The occurrence of postoperative ileus was correlated with the duration of operation, but not with laparoscopic appendectomy. The authors conclude that further investigation will likely establish that laparoscopic appendectomy can be considered the ‘gold standard.’ 2 tables. 37 references. (AA-M).

Major Descriptors (MJ): Digestive System Diseases. Appendicitis. Laparoscopy. Research. Quality of Care.

Minor Descriptors (MN): Surgical Techniques. Surgery. Patient Selection. Postoperative Complications.

Verification/Update Date (VE): 199510.

Notes (NT): CP: Yes.

Accession Number (AN): DD JA 04876.

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17. Surgical Management of Intra-Abdominal Inflammatory Conditions During Pregnancy.

Subfile: Digestive Diseases

Format (FM): JOURNAL ARTICLE (24). REVIEW (46).

Language(s) (LG): English.

Year Published (YR): 1995.

Audience code (AC): HEALTH PROFESSIONALS (100).

Author (AU): Fallon, W.F., Jr., et al.

Series (SE): (Surgery in the Pregnant Patient).

Source (SO): Surgical Clinics of North America. 75(1): 15-31. February 1995.

Availability (AV): Available from W.B. Saunders Company, Periodicals Fulfillment, 6277 Sea Harbor Drive, Orlando, FL 32887. (800) 654-2452.

Abstract (AB): In this journal article, from a special issue on surgery in the pregnant patient, the authors review the surgical management of intra-abdominal conditions during pregnancy. The article covers appendicitis, including diagnosis, operative treatment, and maternal-fetal outcome; biliary tract disease, including symptoms, management, surgical treatment, and maternal-fetal outcome; liver disease, including diagnosis, management, and maternal-fetal outcome; imaging, including the choice of imaging modality, upper abdominal disorders, and the lower abdomen and pelvic region; and the use of empiric antibiotic therapy. The authors caution that delays in diagnosis and definitive treatment represent the most significant risk factor for both mother and fetus in these cases. 1 figure. 2 tables. 39 references.

Major Descriptors (MJ): Digestive System Diseases. Pregnancy. Surgery. Appendicitis. Biliary Tract Diseases. Liver Disease.

Minor Descriptors (MN): Diagnostic Tests. Diagnosis. Mortality. Morbidity. Risk Factors. Surgical Techniques. Drug Therapy. Antibiotics.

Verification/Update Date (VE): 199601.

Notes (NT): CP: Yes.

Accession Number (AN): DD JA 04989.

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18. Historical Overview of the Recognition of Appendicitis.

Subfile: Digestive Diseases

Format (FM): BOOK CHAPTER (09).

Language(s) (LG): English.

Year Published (YR): 1995.

Audience code (AC): HEALTH PROFESSIONALS (100).

Author (AU): Smith, D.C.

Source (SO): In: Chen, T.S., and Chen, P.S., eds. History of Gastroenterology: Essays on Its Development and Accomplishments. New York, NY: Parthenon Publishing Group, Inc. 1995. p. 173-193.

Availability (AV): Available from Parthenon Publishing. 1 Blue Hill Plaza, P.O. Box 1564, Pearl River, NY 10965. (800) 735-4744 or (914) 735-9363. Fax (914) 735-1385. PRICE: $88.00 (as of 1996). ISBN: 1850703655.

Abstract (AB): This chapter, from a compilation of essays that relate the emergence and history of the field of gastroenterology, provides a historical overview of the recognition of appendicitis. The author contends that appendicitis is one of the examples of successful surgery that contributed to a renewed acceptance of the medical profession in the late 19th and early 20th centuries. Topics include early understanding of the pathological lesions of the appendix, surgical intervention using the Willard Parker operation, the dissemination of Parker’s operation, problems with infection with abdominal surgery, the surgical management of peritonitis, diagnostic controversies, diagnosis and the probability of perforation, the work of Reginald H. Fitz, and medical versus surgical approaches to appendicitis. 13 figures. 120 references.

Major Descriptors (MJ): Digestive System Diseases. Gastroenterology. History of Medicine. Appendicitis.

Minor Descriptors (MN): Physiology. Surgery. Surgical Techniques. Diagnosis. Diagnostic Tests. Symptoms. Peritonitis. Prevention.

Verification/Update Date (VE): 199610.

Notes (NT): CP: Yes.

Accession Number (AN): DD BK 05393.

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19. When You Need an Operation: About Appendectomy.

Subfile: Digestive Diseases

Format (FM): BROCHURE/PAMPHLET (08).

Language(s) (LG): English.

Year Published (YR): 1994.

Audience code (AC): PATIENT (400).

Corporate Author (CN): American College of Surgeons.

Series (SE): (When You Need an Operation Series, Number 6).

Source (SO): Chicago, IL: American College of Surgeons. 1994. 4 p.

Availability (AV): Available from American College of Surgeons. 55 East Erie Street, Chicago, IL 60611. (312) 664-4050 PRICE: $14 for 50 copies, $27 for 100 copies.

Abstract (AB): This brochure provides information for patients scheduled to undergo an appendectomy, the surgical removal of the appendix. Written in a question-and-answer format, the brochure describes the procedure; the anatomy and function of the appendix; appendicitis; diagnosing appendicitis; preparation for surgery; the surgical procedure, including open and laparoscopic techniques; recovery from the operation; and possible complications. The brochure includes a description of the specialized training required for surgeons and for certification as a Fellow of the American College of Surgeons. 1 figure.

Major Descriptors (MJ): Digestive System Diseases. Appendix. Surgery. Patient Education.

Minor Descriptors (MN): Surgical Techniques. Appendicitis. Postoperative Complications. Diagnosis. Laparoscopy.

Verification/Update Date (VE): 199504.

Notes (NT): CP: Yes.

Accession Number (AN): DD BR 04552.

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20. Appendicitis.

Subfile: Digestive Diseases

Format (FM): VIDEORECORDING, VIDEOCASSETTE TAPES (84).

Language(s) (LG): English. Spanish.

Year Published (YR): 1994.

Audience code (AC): PATIENT (400).

Corporate Author (CN): Altschul Group Corporation.

Series (SE): (Medicine Demystified: A Guide to Self-Health Series).

Source (SO): Evanston, IL: Altschul Group Corporation. 1994.

Physical description (PD): 1/2 in VHS videocassette (13 min, 30 sec), color.

Availability (AV): Available from Altschul Group Corporation. 1560 Sherman Avenue, Suite 100, Evanston, IL 60201. (800) 421-2363 or (708) 328-6700. Fax (708) 328-6706. PRICE: $179 (as of 1995) plus $3 shipping; bulk discounts available. Program Number 7878.

Abstract (AB): This videotape, from a self-health series of patient education videos, explains appendicitis. The series emphasizes lifestyle and environmental factors that increase the risk of illness, the impact of health problems on individuals and society, and a better understanding of bodily functions in order to detect signs and symptoms of wellness and illness. This program reviews the symptoms of an appendicitis attack, tells how the appendix is removed, who appendicitis usually affects, and lists possible complications. The program is available in both English and Spanish. (AA-M).

Major Descriptors (MJ): Digestive System Diseases. Appendicitis. Patient Education.

Minor Descriptors (MN): Audiovisual Aids. Risk Factors. Symptoms. Surgery. Complications. Surgical Techniques.

Verification/Update Date (VE): 199510.

Notes (NT): CP: Yes.

Accession Number (AN): DD AV 04860.

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